Modified prone position using lateral brace attachments for cervico-dorsal spine surgeries

Abstract

Purpose The purpose of the study was to propose a method of prone positioning for posterior cervico-dorsal spine surgeries that is easy to achieve without additional equipment and may reduce complications associated with prone positioning in patients. Methods 41 patients underwent posterior spine surgeries using our method of prone positioning on a fluoroscopy compatible conventional operation table, and the technical difficulties and complications associated were noted. After induction under general anaesthesia in supine position, cervical tongs were applied. An assembly of two adequately padded cylindrical bolsters and two lateral brace attachments was set on a conventional operating table. The patient was then positioned prone so that the tongs as well as insertion pins of the tongs rest on the lateral brace attachments, with the face and head suspended freely in between. A neutralisation weight was then applied suspended from the tongs to stabilize the head. Results The time required for patient positioning was noted and was found to be nearly the same as that required for traditional prone positioning. No problems were noted during patient positioning and with anaesthesia tubing management. All surgeries went well without position related complications except for one patient who developed post-operative macroglossia. All cervical tong pin sites healed without any complications. The fluoroscope easily gained access to the operative areas.Conclusions Our modification appears simple, versatile and reproducible for posterior approach procedures of the cervical and upper dorsal spine in prone position. Also, the method can be easily implemented in most conventional operating room facilities with minimal surgeon effort and without the need for any additional inventory.

An Innovative Prone Position Using a Body-Shape Plaster Bed and Skull Traction for Posterior Cervical Spine Fracture Surgeries

“…The traditional prone position has no fixation of the patients' head, body, and operating table, so it is impossible to ensure the stability of patients when adjusting the operating table and the traction direction during the operation, which may lead to a respiratory passage compression and asphyxia. Additionally, Kadam et al ( 2 ) proposed a modified prone position for posterior cervical spine surgeries using a cervical tong for traction and two lateral brace attachments on an operating table, which can avoid a localized pressure over the eyeballs and the face skin associated with the horseshoe headrest. However, this modified prone position has the inability to intraoperatively readjust the position and tilt the table beyond 30° to either side.…”

“…The prone position is widely used globally for posterior cervical and dorsal spine surgeries ( 1 ). To date, the traditional posterior approach to the surgical stabilization of the head and the cervical spine is usually achieved by the horseshoe headrest ( 2 ). This system, however, has many shortcomings, such as being unavailable and unstable for position adjustment during surgery.…”

A Modified Prone Position Using A Body-Shape Plaster Bed and Skull Traction for Posterior Cervical Spine Surgeries

“…The traditional prone position has no xation of the patients' head, body and operating table, so it is impossible to ensure the stability of patients when adjusting the operating table and traction direction during the operation, which may lead to respiratory passage compression and asphyxia. Additionally, Kadam AB et al [2] proposed a modi ed prone position for posterior cervical spine surgeries using cervical tong for traction and two lateral brace attachments on an operating table, which can avoid localized pressure over the eyeballs and face skin associated with horseshoe headrest.…”

“…The prone position is widely used for posterior cervical and dorsal spine surgeries around the world [1]. To date, the traditional posterior approach to surgical stabilization of the head and the cervical spine is usually achieved by the horseshoe headrest [2]. This system, however, has many shortcomings, such as being unavailable and unstable for position adjustment during surgery.…”

Eye Care Interventions in Critical/Surgical Patients in the Prone Position: Scoping Review

“…Regarding eye care in patients with COVID-19, the authors did not present any intervention other than those recommended in uncontaminated patients. Because it is a recently discovered virus, further studies are needed to define care with lower infection risks (25,27,30) . Among the interventions, lubricants and eye protection with adhesive tape were the most frequent in the sample for critically ill patients, followed by eye examination and cleaning with saline.…”